Impact of psychosocial factors on cardiovascular morbimortality: a prospective cohort study

BMC Cardiovascular Disorders

Research Article

Olga Castañer¹  José Lapetra²  Miquel Fiol³  Emilio Ros⁴  Ramón Estruch⁵  Rosa-Maria Lamuela-Raventos⁶  Dolores Corella⁷  José-V Sorlí⁸  Jordi Salas-Salvadó⁹  Valentina Ruiz-Gutiérrez^1,10  Josep Basora^1,11  Javier Díez-Espino^1,12  Miguel-Ángel Muñoz^1,13  Cília Mejía-Lancheros^1,14  Fernando Arós^1,15  Lluís Serra-Majem^1,16  Enrique Gómez-Gracia^1,17  Xavier Pintó^1,18  Miguel-Angel Martínez-González^1,19 

[1] CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;Cardiovascular Risk and Nutrition Research Group of Institute Hospital del Mar (IMIM), Barcelona, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;Department of Family Medicine, Primary Care Division of Seville, San Pablo Health Center, Seville, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;Institute of Health Sciences (IUNICS), University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;Lipid Clinic, Department of Endocrinology and Nutrition of Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Department of Internal Medicine of Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia dels Aliments, Instituto de Investigación en Nutrición y Seguridad Alimentaria, University of Barcelona, Barcelona, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Department of Preventive Medicine, University of Valencia, Valencia, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Department of Preventive Medicine, University of Valencia, Valencia, Spain;Primary Care Division, Valencia Institute of Health, Valencia, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Human Nutrition Department, Hospital Universitari Sant Joan, Institut d’Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Instituto de la Grasa, Consejo Superior de Investigaciones Científicas, Sevilla, Spain;CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Primary Care Division, Institut Català de la Salut, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Tarragona-Reus, Spain;Centro de Salud de Tafalla, Servicio Navarro de Salud, University of Navarra, Pamplona, Spain;Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain;Institut Català de la Salut, Barcelona, Spain;Institut d’Investigació en Atenció Primària IDIAP-Jordi Gol, Barcelona, Spain;Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain;the PREDIMED Study Investigators, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Department of Cardiology, University Hospital of Alava, Vitoria, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Department of Preventive Medicine, University of Malaga, Malaga, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain;PREDIMED (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain;

关键词: Stroke;    Acute myocardial infarction;    Cardiovascular death;    Educational level;    Socioeconomic position;    Depression;    Social support;    Health inequalities;   

DOI  :  10.1186/1471-2261-14-135

 received in 2014-06-27, accepted in 2014-09-22,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundWhilst it is well known that psychosocial determinants may contribute to cardiovascular diseases (CVD), data from specific groups are scarce. The present study aims to determine the contribution of psychosocial determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD, in a high risk adult population.MethodsLongitudinal prospective study of 7263 patients (57.5% women), mean age 67.0 (SD 6.2) free from CVD but at high risk, with a median follow-up of 4.8 years (from October 2003 to December 2010). The Hazard Ratios (HRs) of cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes) related to educational attainment, diagnosed depression (based on medical records), and low social support (number of people living in the household) were estimated by multivariate Cox regression models.ResultsStroke incidence was associated with low educational level in the whole population (HR: 1.83, 95% CI: 1.09–3.09), and especially in men (HR: 2.11, 95% CI 1.09–4.06). Myocardial infarction and CVD mortality were not associated with any of the psychosocial factors considered.ConclusionAdults with low educational level had a higher risk of stroke. Depression and low social support were not associated with CVD incidence.Trial registrationClinical trial registration information unique identifier: ISRCTN35739639.

【 授权许可】

Unknown   
© Mejía-Lancheros et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.